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Thursday, April 18, 2013

Nowadays, people (including friends and family) ask me, "So, what are you up to these days, doctor? Which hospital? Are you a specialist yet?"; and all I can give is a wry smile and tell them about the situation of Indian medical education system and the NEET case..

The above question has entered the category where you don't ask a woman her age or a man his salary; or, in this case, a doctor about the NEET case/results!

Yesterday I saw a comment on my post by a concerned mother asking me about updates on the NEET-UG case. I gave her a site that I thought would help ease her stress, although in my heart I wanted to tell her to discourage her daughter to enter this profession.. I think most of my peers would agree with me.. Poor girl! She still has time to take a safer and better path! :-\ Such is the discontentment amongst medical students now..

Medical education is tough. Requires a lot of hard work. And its time consuming too! Tell me another graduation course that takes almost 6 years of study.. Most doctors dedicate the best part of their life to serve the community.. And this is how the government and corporates reward us.

It's all about money.. All about the profits. It's no more about the merit or honor or the compassion.. It's just "good business". And the business has become so good that every time I see a research by a doctor, I wonder, is this research transparent? Or, is it just another hoax to perpetuate a disease or situation to profit!? Health is no more the wealth, money is..

The idea of NEET (National Eligibility-cum-Entrance Test) became quite popular amongst most medical students.. It promised something that was a rarity before it -- transparency, standardization and increased seats.. Students got bored of the type of questions that were being asked in the AIPGMEE.. Students started studying more for exams.. The exam started becoming more crooked.. And the students started studying much more.. A vicious cycle that had led to the situation where the questions in AIPGMEE didn't make any sense, and students had stopped going to hospitals for internship and started going to coaching institutes to crack exams.. And then there was the competition.. AIPGMEE just had a percentage of seats from just the government colleges! And there were individual state exams. So, a student had to spend a lot of money and energy on filling numerous forms for entrance to different exams.. And all exams had different standards.. So, one needed to buy specific course/guide books for all these different exams.. And if you have gone through the above link on 30 billion dollar scam, you'd know that corruption was so deep that the exams were not transparent anymore (except AIPGMEE and some others).. So, there were people profiting from every part of this "business". Be it the politicians' private hospitals, or be it the authors of so many guide books and their publishers, and also the coaching centers! With NEET, all get stripped out.. The "business" goes kaput! I'd say a serious blow to a lot of jobs! With NEET there'd be one standard exam.. Students won't need to purchase so many forms and give so many exams. Just one transparent, standard exam.. And since all the colleges in India will have to give all their seats, there'll be an increase in number of seats and fairer opportunity. I agree, the exam that NEET took this year had very bad questions. But they could become better eventually. I also realized that they were not the usual bookworm questions. They were more practical questions. If NEET could actually inculcate asking such questions, won't it be good? Students would start going for internship, instead of cramming infinite knowledge for nothing. I think that would produce better doctors..

But then we have the NEET case.. It looks like some institutes are asking for their rights to conduct their own standard of exam and teachings. They are against this national standardization.. Yeah, one has the right to use their own recipe to make their own cake and the right to sell it in the market.. But this is making of doctors we are talking about, not the making of cakes, are we?

OK, FINE!! You filed a case.. Now what? Court is taking it's sweet time to give a verdict. A verdict was expected on 17th January, but the case is still going on, as of 18th April…. And still no verdict. This article was a call to the Health minister to look at the situation seriously.. But I am yet to see any effect.. But then something amazing happened!! Supreme court went on to drop the NEET case for a day to take up a rather important and critical (and I mean in the most sarcastic of senses) case on banning internet pornography. Check here.

Now there were some bomb blasts in Bangalore, as if the world was not already ending, and that too so close to some political party's place with elections near.. Damn these terrorists! Don't they get some other time or some other place! :-\

Anyway, life of most medical students, including me, have entered the doldrums. I, for instance, appeared in an interview out of the frustration of waiting for the results. Although I supposedly cleared the interview, I never got the joining letter after the medical check-up.. When inquired, was told that it was maybe due to my eye power.. Board regulations there was +/- 4 D. And I have -4.5 in one eye! Most other students have been asked to commit for 6 months or something to get a job, which they can't because of the delayed results.. So, no job, no results.. On the funnier side, I hear a lot of them are misplacing their admit cards for the exam!! Lol! Can it get any worse?

Some are of the opinion that maybe they won't give results this year. But that is not possible.. Let me tell you why. In medical post graduation one has to work in the hospital, and are known as Residents. PG is a 3 years course. So, apart from the consultants/Senior doctors who work in the hospitals, it's the Residents and nurses who actually do the mundane.. So, if you see, almost all hospitals are working because of the 3 year Residents in each department.. Now if results were not declared, there'd be no 1st year residents! And it’s the 1st year residents who do the maximum work in most hospitals. And usually 3rd year residents don't give much time because of their upcoming final exams. So, with no 1st year and no 3rd year, all burden will land on 2nd years.. All hospitals will become under-staffed!! And if that does happen, I won't be surprised if the 2nd year residents go on a strike because of increased work load!! Lol! And that will result a load on the senior consultants and 3rd years.. Maybe the hospitals would just stop… Phew! Nah! Don't think that's gonna happen.. They might delay results or might even give a bad verdict, but results are coming soon..

So, the question isn't whether they will give or not. The question is whether the verdict will be a fair one. It has become so hard to speculate at the moment!

Medical students are fighting for their rights. Trying to trend #SaveNEETPG on Twitter so as to make mainstream media to cover this issue.. But after covering the sting operation, media seems satisfied with the issue. Nobody wants to cover the issue.. We are writing online petitions to support the cause.. Have written 2 so far..

As it is the Doctor-patient ratio is very bad in India. There's shortage of doctors! I want to ask the Government, why can't they increase the number of seats? Why can't they open new recognized colleges? Why can't they increase the expenditure on health? I have heard if you ask them, they'll give you it in terms of Rupees and say ,"See, we have increased the expenditure".. But what they would not show or see that the %GDP used is still 1% by the government.. ONE PERCENT!!! And it's been 1% for ages!! Check my post "Health in India" for the data I dug out from WHO database. You will see the other countries I have compared with, have happily revised their expenditure and increased it!

Jacques Fresco, social engineer of The Venus Project, rightly said that you can't talk about ethics in a Monetary Based Economy. I think this is exactly what is happening. One may unearth millions and billions of dollars from Swiss accounts, and "scams" might become like "spam" in India, and 90,000 medical students might die trying to save NEET PG, but elites are busy making more and more money.

Whoever had said that the world was ending in December 2012, had a very shrewd sense of metaphor and cruel sense of humour with respect to the medical students in India.

Hoping against all odds that Supreme court may give a fair verdict and corruption might be decreased if not ended. Till then, we are fighting for our rights. If you are reading this, you might as well open the aforesaid two petition links and sign them. It doesn't matter if you are a doctor or not. Do help us win this fight against corruption.

Saturday, April 6, 2013

Let me
tell you a story to chill the bones and it’s not the song Dance of the Death by
Iron Maiden.. :D

Recently,
a sting operation had uncovered the selling of medical post graduate seats in
India. Can you believe that? I was quite shocked.. No, not because I came to
know this for the first time that seats were being sold, but that the price
they were being sold at, and that seat bookings were done for the future as far
as 2016!!

CNN-IBN
covered it live the other day.. These guys went in with a camera and asked
these hospital people if they could get a seat in PG in their college. And
these guys happily told them that they could get whatever they wanted.. Every
department had their rate like some Continental Restaurant Menu card!
Pediatrics, Radiology, Medicine, Surgery, etc.. Up to ₹2 crores!! 2 freaking
crores.. 2,00,00,000!! That is ₹20million!! Approximately US$ 363,899! Donno
what they'd be serving for desserts though! And that's for one seat.. And then
perhaps there's some provision for early bird prizes, too! I mean bookings have
be done for seats up till 2016!! Advanced booking… Something like a pre-release
sale or something. Can you imagine how lucrative this business of seat selling
is? And the best thing is that they won't give a receipt.. So it's tax free!!
:D

And then
there was a lot of heated arguments of what the problem is.. And I think the
problem comes to just few of the following very important things:

Doctor-Patient Ratio: India has an abysmal, to say
the least, Doctor-Patient ratio. In my last post titled "Satyamev
Jayate" I had given the data of how for every doctor there is 1953
patients in India as of 2012. Thus, the number of doctors are very less..

Medical Institutes: The number of Medical
institutes are very less. There are 355 Medical Colleges in India.. Out of
which 161 are Government colleges and 194 are Private colleges.. With even
full turnover of doctors at 44250 doctors per year from these 355 colleges
the doctor patient ratio wont come down enough.. But that of course never
happens..

Expenditure on Health: The % of GDP used in health
services in India is 3.9% as of 2011!

Total %GDP expenditure on Health in India

And Government just uses 1% of GDP in health services.

%GDP expenditure on Health by Government of India

The above 2 tables show the data compared to some other countries..

Now why
won't there be corruption!

Every
student after completing their MBBS want to get into an MD/MS/Diploma course..
The total number of seats are 21282.. So, of the 44250 MBBS students per year,
only 21282 students get into a post graduate course! Not even 50%!! And the
expenditure on health by India is also very low!

What can be the solution to the problem?

Increase
the number of medical colleges. Increase the number of post graduate seats.
Increase the expenditure on health..

And in
India it is mostly seen that the private colleges are profit driven and thus
are corrupt.. India needs to open more and more government colleges. Indian
government should increase their %GDP expenditure on health from a meager 1.2%
to somewhere around 6%. Is it asking much?

Right now
this fight for getting into a post graduate degree is causing all the
corruption.. Like it's said, Scarcity increases profits.. Make seats abundant,
there'd be less corruption. No chance for making profits.. And moreover when
the expenditure on Health will be increased, Institutes won't be bankrupt to
think about profits through illegal means!

And after
that, even the education system needs to be polished, so that good doctors are
produced..